TY - JOUR
T1 - Quadriceps wasting and physical inactivity in patients with COPD
AU - Shrikrishna, Dinesh
AU - Patel, Mehul
AU - Tanner, Rebecca J.
AU - Seymour, John M.
AU - Connolly, Bronwen A.
AU - Puthucheary, Zudin A.
AU - Walsh, Simon L.F.
AU - Bloch, Susannah A.
AU - Sidhu, Paul S.
AU - Hart, Nicholas
AU - Kemp, Paul R.
AU - Moxham, John
AU - Polkey, Michael I.
AU - Hopkinson, Nicholas S.
PY - 2012/11/1
Y1 - 2012/11/1
N2 - Quadriceps weakness is an important complication of advanced chronic obstructive pulmonary disease (COPD) but few data exist concerning muscle bulk in early disease. We hypothesised that quadriceps bulk, measured by ultrasound rectus femoris cross-sectional area (USRFCSA), would be reduced in mild, as well as advanced, COPD compared with controls, and would correlate with physical activity. 161 patients with stable COPD and 40 healthy subjects had a measurement of USRFCSA and wore a multisensor armband to record physical activity. USRFCSA was reduced in Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I patients compared with healthy subjects (p=0.0002). Stage II-IV patients had reduced USRFCSA (p<0.0001) compared with controls but were not significantly different from those with stage I disease. Physical activity level was reduced in stage I (p=0.002) and stage II-IV disease compared with controls. Using regression analysis, physical activity level was independently associated with USRFCSA in stage I (p=0.01) but not stage II-IV disease, where residual volume to total lung capacity ratio was the only independent predictor of physical activity level. Quadriceps wasting exists in patients withmild, as well as advanced, COPD, and is independently associated with physical inactivity in GOLD stage I disease. The identification of these patients may guide early lifestyle and therapeutic interventions.
AB - Quadriceps weakness is an important complication of advanced chronic obstructive pulmonary disease (COPD) but few data exist concerning muscle bulk in early disease. We hypothesised that quadriceps bulk, measured by ultrasound rectus femoris cross-sectional area (USRFCSA), would be reduced in mild, as well as advanced, COPD compared with controls, and would correlate with physical activity. 161 patients with stable COPD and 40 healthy subjects had a measurement of USRFCSA and wore a multisensor armband to record physical activity. USRFCSA was reduced in Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I patients compared with healthy subjects (p=0.0002). Stage II-IV patients had reduced USRFCSA (p<0.0001) compared with controls but were not significantly different from those with stage I disease. Physical activity level was reduced in stage I (p=0.002) and stage II-IV disease compared with controls. Using regression analysis, physical activity level was independently associated with USRFCSA in stage I (p=0.01) but not stage II-IV disease, where residual volume to total lung capacity ratio was the only independent predictor of physical activity level. Quadriceps wasting exists in patients withmild, as well as advanced, COPD, and is independently associated with physical inactivity in GOLD stage I disease. The identification of these patients may guide early lifestyle and therapeutic interventions.
KW - Mild chronic obstructive pulmonary disease
KW - Skeletal muscle
KW - Ultrasound rectus femoris cross-sectional area
UR - http://www.scopus.com/inward/record.url?scp=84864009994&partnerID=8YFLogxK
U2 - 10.1183/09031936.00170111
DO - 10.1183/09031936.00170111
M3 - Article
C2 - 22362854
AN - SCOPUS:84864009994
VL - 40
SP - 1115
EP - 1122
JO - European Respiratory Journal
JF - European Respiratory Journal
SN - 0903-1936
IS - 5
ER -